Current situation of labor epidural analgesia in Japan: a cross-sectional study

Mazda, Yusuke; Uokawa, Reiko; Tanabe, Serabi; Ootaki, Chiyo

doi:10.1016/j.ijoa.2020.07.001

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…In some developed countries, the rate of childbirth analgesia can reach approximately 80%. In recent years, the rate of childbirth analgesia in China has increased annually [ 7 , 8 ]. Pain during delivery activates the sympathetic nervous system, resulting in a significant increase in catecholamine levels in maternal blood.…”

Section: Discussionmentioning

confidence: 99%

Effect of nalbuphine plus ropivacaine on vaginal labor in epidural analgesia

Liu,

et al. 2023

BMC Anesthesiol

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Background Various approaches using epidural analgesia have been employed for relieving labor pain and promoting spontaneous delivery. We aimed to evaluate the effect of nalbuphine and ropivacaine versus fentanyl and ropivacaine on the duration of delivery in parturients. Methods Clinical data of 160 full-term primiparous women who received either nalbuphine or fentanyl in combination with ropivacaine infusion for epidural labor analgesia in our hospital from December 2020 to May 2022 were retrospectively analyzed. The participants were divided into two groups based on anesthesia methods: nalbuphine group (NR group, n = 78) received 0.2 mg/mL nalbuphine combined with 0.1% ropivacaine hydrochloride for patient-controlled epidural analgesia (PCEA) and fentanyl group (FR group, n = 82) received 2 ug/mL fentanyl citrate and 0.1% ropivacaine hydrochloride for PCEA. Both groups received an epidural blockade for labor analgesia at lumbar 2–3 interspace. The duration of the first, second, and third stages of labor, the onset of analgesia, and time before delivery (T0), 15 min of analgesia (T1), 30 min of analgesia (T2), full opening of the uterine opening (T3),exerts force during childbirth(T4), heart rate (HR), blood pressure (BP), blood saturation (SpO2), visual analogue pain scale (VAS) score, Ramsay sedation score, and modified Bromage score, and 5 min were recorded at 2 h postpartum (T5). The neonatal Apgar score, neonatal behavioral neurological assessment (NBNA) score, maternal nausea, vomiting, and itchy skin were recorded. Results Compared with the FR group, the first stage of labor duration (p < 0.05) and total duration of labor (p < 0.05) were shortened and the onset of analgesia (p < 0.05) was increased in the NR group. NR group had lower incidence of urinary retention than FR group (p < 0.05). The maternal and neonatal investigational parameters and scores had no significant difference between the two groups. Conclusions Nalbuphine combined with ropivacaine in epidural block labor has a faster onset of analgesia and has a lower incidence of urinary retention than fentanyl combined with ropivacaine, and nalbuphine shortens the duration of the first and total stages of labor. Both nalbuphine and fentanyl can reduce pain during labor, have little effect on maternal hemodynamics, and have no significant effect on neonatal Apgar or NBNA scores.

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Section: Discussionmentioning

confidence: 99%

Effect of nalbuphine plus ropivacaine on vaginal labor in epidural analgesia

Liu,

et al. 2023

BMC Anesthesiol

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Initiation of Obstetric Analgesia for Labor and Delivery in Our Hospital

Kijima

Takagi

Yumoto

et al. 2023

Nichidai Igaku Zasshi

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Although the efficacy rate of epidural analgesia during labor and delivery in Japan is lower for various reasons than that in Western countries, the number of pregnant women who want painless delivery is gradually increasing. To meet a growing need for obstetric analgesia for labor and delivery in our hospital, our team consisting of anesthesiologists, gynecologists, birthing assistants and medical processors has started to provide analgesia for labor since last year, and the number of cases has been steadily increasing. For safe and effective analgesia, we deliberately discussed and prepared a manual to use mainly combined spinal and epidural anesthesia for initial analgesia, followed by a combination of patient-controlled analgesia and programmed intermittent epidural bolus. Importantly, all perinatal staff should be aware of both anesthesia-related and delivery-related complications and communicate how to adequately treat them to facilitate safe and smooth delivery.

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Current situation of labor epidural analgesia in Japan: a cross-sectional study

Cited by 2 publications

References 4 publications

Effect of nalbuphine plus ropivacaine on vaginal labor in epidural analgesia

Effect of nalbuphine plus ropivacaine on vaginal labor in epidural analgesia

Initiation of Obstetric Analgesia for Labor and Delivery in Our Hospital

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